St. Augustine Woman's Journal - Educational Resource to the Women of St. Johns County Since 2009

A Few Insights to Menopause


August 1, 2019 | View PDF

Even though menopause is a normal state and not a disease, some symptoms can be worrisome. In order to dispel some of the mystery surrounding menopause, I will try to answer some the most common questions we get at a healthcare visit.

1. What is Menopause?

Menopause is the complete cessation of your period due to hormonal changes associated with the natural aging of the ovaries. During this phase there is a decline in the production of female hormones (estrogen and progesterone). Once you have gone twelve months with no period you have reached menopause. Sometimes you may see the word CLIMACTERIC used interchangeably with MENOPAUSE. Climacteric is closely associated with the symptoms of menopause while menopause refers to the specific event.

2. What is climacteric syndrome?

Symptoms associated with menopause can happen even before a woman reaches menopause. The main symptom of menopause is not having a period. Other symptoms may include the following:

• Hot flashes

• Vaginal dryness

• Urinary symptoms

• Skin changes

• Memory changes

• Sleep disturbances and fatigue

3. What is peri-menopause?

Menopause does not happen abruptly. Women will start to experience symptoms associated with the decrease in hormone production sometime in their 40s or 50s. Menstrual irregularities to cessation of a menstrual cycle are a transitional period called peri-menopause. This transitional period may last several years. A woman can experience climacteric symptoms even before she notes changes in her menstrual cycle.

4. At what age does menopause usually occur?

The average age for menopause is 51. There are some factors that can impact onset of menopause such as family history, smoking status, chemotherapy, ovarian surgery and ethnicity. Things that will not impact the onset of menopause are the age at which a woman started her period, breastfeeding or contraceptive use.

5. How does menopause impact my bones?

After menopause, bone loss increases as the capacity of the body to produce bone tissue decreases. This thinning of bones with reduction bone mass is called osteoporosis. Bones become fragile which increases the risk for fracture risk especially in the spine, wrist and hip (femur neck). Early menopause, family history, lack of physical activity, smoking and vitamin d deficiency can increase the severity of the impact on the bones.

6. Are there cardiovascular risks associated with menopause?

Prior to menopause, cardiovascular diseases are less common in women when compare to men. At the onset of menopause, women are less protected and the risk of developing cardiovascular disease starts to increase. There are risk factors that can increase a woman’s risk of developing cardiovascular disease in menopause including smoking, obesity, pre-existing chronic conditions and sedentary lifestyle.

7. What are some of the advantages of taking hormone replacement therapy (HRT)? And would I benefit?

The decision to initiate HRT should include a discussion between a woman and her healthcare provider. If there is a presence of climacteric symptoms interfering with activities of daily living then initiating HRT may improve quality of life. HRT is most effective medical treatment for hot flashes, night sweats and fatigue. HRT is also reduces the risk for osteoporosis and deceases risk for developing colon cancer. Vaginal dryness or pain with sex can be reduced with HRT, including vaginal creams and inserts.

Bio-T is another treatment option to address climacteric symptoms. Hormonal pellets can be placed under the skin by a healthcare professional. The pellets consistently release estradiol and testosterone into the bloodstream. Bio-T has been shown to increase energy, restore libido and help with weight loss.

MonaLisa is a therapeutic laser used to restore collagen, elastin and ad vascularization of the vaginal tissue. This in turn will help improve discomfort with sex and vaginal dryness.

8. Are there any women that cannot take hormone replacement therapy (HRT)?

There are some chronic conditions that may exclude a woman from choosing traditional HRT as a treatment for symptoms including the following:

• Liver disease

• Breast, ovarian or uterine cancer

• Stroke

• Blood clots in the legs or lungs

• it has been 5 years since you had a period

9. Are there “natural” alternatives to hormone replacement therapy?

It is important to discuss your symptoms before starting any “natural” remedies, including herbal supplements as these may have side effects similar to traditional medicines. Taking steps to improve your overall health may also improve your hot flashes. Eating foods high in calcium and vitamin D, avoiding alcohol, exercising regularly and getting enough rest are important ways to impact your hot flashes.

Dr. Needham graduated with a degree in Biochemistry and Genetics from the University of Reims, France. She attended and graduated from University Medical School of King Hassan II in Casablanca, Morocco. Dr. Needham trained as a ob-gyn resident at Franklin Square Hospital Medical Center in Baltimore, Maryland, as well.

Academic Background:

• B.S., University of Reims, France

• M.D., University of King Hassan II, Morocco

• Residency, Franklin Square Hospital Center, an affiliate of The Universityof Maryland

OB-GYN has always fascinated her at an early age. She knew one day she would be set to take care of her family of six sisters. Dr. Needham enjoys all aspects of OBGYN, particularly minimally invasive surgeries and primary infertility. In 2009 she found herself opening her private practice in Palatka and St. Augustine.

“My life is complete…. My husband, teenage daughter, 4 dogs, 3 horses, 2 cats, and a bunch of swans. In my spare time I enjoy time at the beach, boating, fishing, and watching basketball games or good movies with my family.“


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